Tic disorder in allergic rhinitis children and adolescents: a case-control study

BACKGROUND

Allergic rhinitis is the most common allergic disease. It can accompany psychological disorders such as tic disorders due to the prolonged course of the symptoms of allergic rhinitis. This pioneer case-control study aims to investigate tic disorders in children and adolescents under 18 years of age diagnosed with allergic rhinitis.

METHOD

The case group in this study consisted of patients who had both allergic rhinitis and tic disorders. Patients with allergic rhinitis without tic disorders were also enrolled as the control group with matched gender and age. Demographic characteristics, tic classifications, and contributing factors for allergic rhinitis and tic disorders were studied among the cases. Tic disorders were evaluated using DSM-5 criteria for the classification of tic disorders.

RESULTS

47 patients in the case group and 47 patients in the control group were included in this study. 53.2% and 46.8% were males and females in the case group, respectively. The mean age of the patients was 10.46 ± 3.97 years old. Sound tics were more common among the patients compared to motor tics. Patients with concomitant AR and tic disorders had more days per week with AR symptoms (P-value ≤ 0.001; OR (every day vs. three days a week = 11.02(2.98, 40.76))). Most patients with sound tick were women (p: 0.026), and most patients with motion tic were in the Provisional tic disorder group (p: 0.001). The history of infantile eczema was seen more in patients without sound tic (p: 0.025), and otitis media was significantly less common among patients with sound tics (p: 0.026). Provisional tic disorder was the most common class among the patients. In the case group (coexistence between allergic rhinitis and tic) compared to the control group, patients had significantly more days with AR symptoms per week.

CONCLUSION

This preliminary study indicates that Provisional tic disorder was the most common classification of tic among patients with allergic rhinitis, especially in patients with motor tics. Asthma in motor tics, a history of food allergy in infancy, and a history of infantile eczema were also common among patients with vocal tics. Also, patients with allergic rhinitis and tic had more severe disease (more symptoms per week) than those with rhinitis alone. These findings emphasize the association of tic disorders with immunological pathways.

Association of IL-8 -251T>A and IL-18 -607C>A polymorphisms with susceptibility to breast cancer - a meta-analysis

BACKGROUND

Previous studies have evaluated the association of IL-8 -251T>A and IL-18 -607C>A polymorphisms with a risk of breast cancer in different populations, but the results remain inconsistent and inconclusive. Thus, we performed this meta-analysis to explore the associations.

METHODS

A comprehensive literature search in PubMed, EMBASE, Web of Science, Scopus, SciELO, SID, and CNKI for all eligible studies published up to October 1, 2020. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the intensity of associations.

RESULTS

A total of 12 case-control studies including seven studies with 2,370 cases and 2,314 controls on IL-8 -251T>A, and five studies with 900 cases and 882 con-trols on IL-18 -607C>A polymorphism were selected. Pooled data showed that IL-8 -251T>A (AT vs. TT: OR= 1.187; 95% CI 1.038-1.356; P = 0.012) and IL-18 -607C>A polymorphisms (A vs. T: OR = 1.205; 95% CI 1.055-1.377; P = 0.006; AA vs. TT: OR = 1.379; 95% CI 1.056-1.802; P = 018; and AA vs. AT+TT: OR = 1.329; 95% CI 1.053-1.678; P = 0.017) were associated with increased risk of breast cancer in overall. Moreover, when the studies were stratified by ethnicity, the IL-8 -251T>A was significantly associated with breast cancer risk in Africans. Publication bias tests provide no evidence of presence of publication bias in a meta-analysis.

CONCLUSION

This meta-analysis results revealed that the IL-8 -251T>A and IL-18 -607C>A polymorphisms are associated with susceptibility to breast cancer. However, further multicenter studies with larger sample sizes in different ethnicities are required to make a better assessment of these associations.

Association of polymorphisms in nucleotide excision repair pathway genes with susceptibility to cutaneous melanoma

BACKGROUND

The effects of single nucleotide polymorphisms (SNPs) at nucleotide excision repair (NER) pathway on susceptibility to cutaneous melanoma (CM) are of great interest. To date, several epidemiological studies have evaluated whether the XPC, XPD, XPG and XPF polymorphisms are associated with CM. However, those studies results are controversial or inconclusive. Therefore, we conducted a study to evaluate the association of seven frequently investigated NER pathway polymorphisms with CM risk.

METHODS

A total of 150 patients dia-gnosed with CM and 150 healthy controls were enrolled in the study. Seven SNPs in the NER pathway including XPC (Lys939Gln and Ala499Val), XPD (Lys157Gln, Asp272Asn, and Arg751Arg), XPG (Asp1104His) and XPF (Arg415Gln) were analyzed by polymerase chain reaction restriction fragment length polymorphism assay.

RESULTS

There was no a significant association between XPC Lys939Gln, Ala499Val; XPD Asp272Asn, Arg751Arg, Arg751Arg; XPF Arg415Gln; and XPG Asp1104His polymorphisms and an increased risk of CM.

CONCLUSIONS

This study results revealed that the XPC, XPD, XPG and XPF polymorphisms were not risk factor for susceptibility to CM. However, more well-designed with larger sample size studies in different populations are necessary to further evaluate and validate our results. Future studies which take into account gene-gene and gene-environment interactions are warranted for more precise evidence and further elucidation of the underlying mechanism of CM.

Association of IL-10-1082G > A, -819C > T and -592C > A polymorphisms with susceptibility to asthma in children: a systematic reviews and meta-analysis

Summary

Studies evaluating the association of IL-10 polymorphisms with risk of pediatric asthma found inconsistent data. Here, we performed a meta-analysis to get a precise estimation of the associations. Relevant studies identified in the PubMed, Scopus, CNKI databases were used to perform a meta-analysis. A total of 23 case-control studies including nine studies with 1298 cases and 1079 controls on -1082G > A, four studies with 622 cases and 603 controls on -819C > T and ten studies with 1480 case and 1462 controls on -592C > A were selected. Overall, there was no a significant association between IL-10 polymorphisms with pediatric asthma risk in global population. When stratified by ethnicity, there was a significant association of IL-10 -1082G > A with pediatric asthma in Asians and Chinese. This meta-analysis result revealed that IL-10 -1082G > A, -819C > T and -592C > A polymorphisms were not associated with pediatric asthma risk in the global population.

Job consultation in patients with psychogenic nonepileptic seizures: Systematic review and survey of physicians' opinion

OBJECTIVES

The objectives of this study were 1) to review the literature about "job/employment and psychogenic nonepileptic seizures (PNES)" and 2) to gather the views of neurologists and psychiatrists on the issue of job consultation in patients with PNES.

METHODS

Phase one involved a systematic literature review; phase two involved the collection of the views of neurologists and psychiatrists, practicing in Fars province, Iran, on the issue of job consultation in patients with PNES. A questionnaire was designed for the purpose of this study.

RESULTS

No studies were identified by the systematic review process on the issue of job consultation in patients with PNES. Of the 87 health-care professionals approached, 63 responded to the survey (response rate: 72%). Respondents included 31 neurologists and 32 psychiatrists. In response to the question "Should all patients with PNES be counseled to pursue any job or profession they would like?", 17 (55%) neurologists and 19 (59%) psychiatrists answered "no" (p = 0.8).

CONCLUSION

While it is possible that some patients with PNES are more likely than other people in the general public to be involved in job-related difficulties (performing duties related to any job, accidents, etc.), there is currently no evidence supporting or refuting this proposition. However, in this study, the majority of the health-care professionals, who often deal with these patients, believed that not all patients with PNES should be counseled to pursue any job or profession they would like (i.e., there should be some restrictions).

Disability benefits in patients with psychogenic nonepileptic seizures: a survey of physicians' opinions

OBJECTIVES

The aim of the current study was to gather the views of healthcare providers practicing in the field of psychogenic nonepileptic seizures (PNES) on the issue of "disability benefits eligibility and PNES".

METHODS

This was a questionnaire study that was sent to all neurologists and psychiatrists practicing in Fars province, Iran. The survey included seven questions: one question about professional qualifications, one question on the participants' personal experience with the topic of interest (i.e., PNES), and five questions probing their opinions about the matter of interest (i.e., the issue of disability benefits eligibility in PNES).

RESULTS

The response rate was 72%. Respondents included 32 psychiatrists and 31 neurologists. In response to the question "Do you think that patients with PNES should be counseled to avoid performing all jobs or professions as long as they have active PNES?", 47 (75%) physicians answered "no" (22 neurologists and 25 psychiatrists; P = .5). In response to the question "Do you think that patients with PNES should be qualified for disability benefits?", 47 (75%) physicians answered "Patients with specific jobs or professions should be qualified for disability benefits" (23 neurologists and 24 psychiatrists; P = 1); while, nobody believed that "All of them should be qualified for disability benefits".

CONCLUSION

While collection of the opinions of physicians is valuable, this is just one piece of the puzzle; future studies should investigate the opinions of other stakeholders. More importantly, investigators should explore whether patients with PNES have any job-related difficulties.

Comparing escitaloipram with sertraline for obsessive and compulsive symptoms in patients with obsessive compulsive disorder: A comparative double blind clinical trial

BACKGROUND

Escitalopram has some unique features among selective serotonin reuptake inhibitors. The aim of this survey is to compare the efficacy of escitalopram with sertraline on obsessive and compulsive symptoms in patients with Obsessive Compulsive Disorder (OCD).

METHODS

In this 12-week double blind controlled randomized clinical trial, 57 patients with OCD were randomly allocated to receive escitalopram or sertraline. Yale Brown obsessive compulsive behavior scale (YBOCS) was used to assess the outcomes. Adverse effects were also recorded.

RESULTS

41 patients (20 in the escitalopram group and 21 in the sertraline group) completed the trial. In the escitalopram group 15 (70%) patients and in the sertraline group 16 (76.19%) patients showed more than 34% decrease in mean YBOCS score at the end of the trial (P=0.531). The two groups revealed significant decrease in YBOCS scores without significant difference (P=0.861) at week 12. No serious adverse effects were reported.

CONCLUSIONS

Our results demonstrated that escitalopram is as effective as sertraline in treatment of obsessions and compulsions in patients with OCD. However, it needs to be noted that our study is preliminary and larger double blind controlled studies are needed to confirm the results.

Comparing the Effects of Sertraline with Duloxetine for Depression Severity and Symptoms: A Double-Blind, Randomized Controlled Trial

BACKGROUND AND OBJECTIVE

Selecting the most effective treatment for major depressive disorder (MDD) is a challenge for clinicians. The aim of this study was to compare the effects of sertraline with duloxetine on major depression signs and symptoms.

METHODS

The trial was a 6-week, randomized, controlled, double-blind study. Sixty-three patients with diagnosis of MDD according to DSM-IV-TR criteria were randomly assigned to receive either duloxetine (31 patients) or sertraline (32 patients). The mean dosage of duloxetine was 55 mg/day (range 40-60 mg/day) and the mean dosage of sertraline was 146 mg/day (range 50-200 mg/day). Subjects were assessed at baseline, and at the end of week 6. Depression severity and symptoms were assessed by 21-item Hamilton Depression Rating Scale (HAM-D).

RESULTS

Of 63 patients who were randomized to treatment, 54 patients including 28 in the sertraline group and 26 in the duloxetine group completed the trial. The HAM-D total score for both groups was significantly reduced at the end of the trial period without significant difference from each other (p = 0.463). Of the symptoms studied, psychomotor retardation, general somatic symptoms and sexual problems improved more in the duloxetine group. On the other hand, agitation, anxiety symptoms and hypochondriasis ameliorated better in the sertraline group. There was no difference between the two groups regarding the other symptoms.

CONCLUSIONS

Our study shows that the antidepressant mechanism of action has influence on its effects on different signs and symptoms. Clinician awareness of an antidepressant's special effects can help in selecting appropriate medicine.

Efficacy of Nepeta Menthoides Boiss and Buhse Freeze-Dried Aqueous Extract on Anxiety of Patients with Depression: A Double-Blind Randomized Controlled Clinical Trial

BACKGROUND

The efficacy and safety of Nepeta menthoides freeze-dried aqueous extract were assessed on the anxiety of patients suffering from depression.

METHOD

Patients received either N. menthoides formulation (400 mg/BID) or Sertraline (50 mg/BID) for 4 weeks. The Beck Anxiety Inventory (BAI) scales were used to assess the anxiety in two-week intervals (2^nd, 4^th, and 6^th weeks). Folin-Ciocalteu and Dowd methods were used to determine the formulation of total phenol and flavonoid contents.

RESULTS

Compared with Sertraline, N. menthoides showed a higher reduction in BAI scores in the 2^nd (16.52±8.07 vs. 21.38±10.98, P<0.05) and 4^th week (11.55±6.74 vs. 20.47±11.53, P<0.05) along with a reduction in the recurrence rate and side effects. Total phenolic and flavonoid contents revealed in the presence of 127.09±0.43 mg GAE/g and 16.93±0.09 mg Q/g of extract.

CONCLUSION

N. menthoides could be effective in the control and introducing a delay in recurrence of anxiety in patients with depression.

Sleep Quality among Patients with Mild Traumatic Brain Injury: A Cross-Sectional Study

OBJECTIVE

To evaluate and describe the sleep quality in seven subscales among the patients with mild traumatic brain injury (TBI) and compare it with normal patterns.

METHODS

This cross-sectional study was conducted within a 6-month period from February to August 2014 in Shahid Rajaei trauma center of Shiraz. Participants were selected randomly from all adult (18-60 years of age) patients admitted during the study period with impression of mild TBI (GCS of more than 13). The patients' sleep quality and demographic characteristics were evaluated by Pittsburgh sleep quality index (PSQI) and self- report questionnaire, respectively. Results were compared with normal data, which extracted from the normative data of PSQI manual.

RESULTS

Overall we included 60 patients with mild TBI with mean age of 36.2±13.4 years. All the patients had sleep disturbance. Among them there were 46 (76.7%) men and 14 (23.3%) women. The subjective sleep quality ( p=0.01), sleep latency ( p=0.01), habitual sleep efficiency ( p=0.01), sleep disturbance ( p=0.01), use of sleep medication ( p=0.01) and day time dysfunction ( p=0.01) were significantly impaired in patients with mild TBI when compared to normal values. There were no difference between men and women regarding the sleep quality. The sleep duration was comparable between the subjects and the normal values.

CONCLUSION

Patients with mild TBI have poor sleep quality which should be considered as one of the main factors in interventions after the injury and it might lead to better quality of life.